[Current status of electroconvulsive therapy in adult psychiatric care in France].

A survey into the practice of electroconvulsive therapy between November 1996 and November 1997 in all the French Psychiatric Public Hospital Services is set out here. Of the 815 questionnaires sent by mail, the authors mention that 48% replied. Among the 391 State Hospital Services which responded, 51% declared having practiced ECT during that period of time. A detailed analysis is supplied regarding the apparatus type, maintainance ECT, anaesthesic used, electrode-positioning, medical indication and side effects. The results are presented, then discussed one by one before being compared with those of a similar study made ten years ago. We can already point out to a significant decline in ECT from the 64% who affirmed having practiced it in 1986 to the 51% the authors found in their survey. This undeniable fact has however to be counterweighed against the marked increase in maintainance ECT (40% against 11% with p < 0.001) and the qualitative improvement of the practical application of that therapy if one has to judge from the modernisation of the apparatus as well as the move towards better security conditions. A tentative evaluation of the impact of the guidelines described in the French Government November 1996 circular is also made. Last but not least, the proper equipment for practising ECT seems to be sadly lacking in many of the Psychiatric Wards. This brings further to the fore the debate, so common in France, regarding the equal distribution of the availability of all medical care to each and every citizen wherever he may be living.